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NHS Direct doctor says... NO testing when taking Metformin

Between my last Hb1Ac of 64 and when I was actually diagnosed last December there was a period of between 12 or 18 months not quite sure of the exact amount of time. But in that time I was not self testing and was not being tested by doctor so I have no idea what my blood sugars levels where in that intervening time.

If I had had the sense and confidence to purchase a meter and self test in that time I may have been able to save myself a lot of trouble and maybe prevented some of the complications I now have.

I can now only guess at what the levels may have been though I have noticed as I do check my blood oxygen levels regularly and have done so for a long time that when blood sugars are high blood oxygen levels are low and I do recall in that intervening time I had some very low blood oxygen levels well down into the low mid 80%s so I think my BG levels must have been very high during that period. So all I can say if any one thinks or suspects that they may be diabetic get a meter and check and don't take any **** from so called medical experts. Because it's your life not theirs.

I'm a fairly recently diagnosed diabetic and I have been given a glucose monitor to test my blood before every meal and at bedtime. At the same time I have been put on Metformin. Frankly I think it's stupid not to test and if I was told not to test I would do so anyway and pay for the monitor and strips myself. How are you meant to know what's happening if you don't test?

The other troubling thing about some doctors and nurses saying no need to monitor is that they don't seem to 'sing from the same song book'. My GP and DN are both brilliant and quite adamant that I keep testing. Not that it gets me any test strips. LOL

Small improvements in blood glucose levels could help the NHS save £5.5 billion and make significant improvements for people with diabetes, according to a study.

Better glucose control could help avoid almost a million serious medical complications associated with diabetes, such as blindness, amputation and kidney failure over 25 years, researchers found.

IMPACT 2 is a study based on data and population modelling. It is the outcome of a collaboration between Diabetes UK, JDRF and Sanofi, and the analysis was completed by IMS and the York Health Economics Consortium.

It looked at people with diabetes and the financial benefit earlier intervention for better controlling blood glucose could have across a 25 year period.

The findings highlighted a significant impact for people with diabetes and NHS budgets could be made if small changes were introduced.

‘Real improvements’

Dr Mike Baxter, consultant advisor to Sanofi Diabetes and lead author of the study, said: “Diabetes is a major healthcare problem with a large and increasing number of people in the UK suffering from avoidable microvascular complications such as kidney disease and foot amputations because their blood glucose levels are too high.

“IMPACT 2 quantifies the reduction in the number of complications, and the potential cost avoidance if modest improvements to patients’ blood glucose levels were made.

“There is the potential to generate real improvements in outcomes for patients with diabetes by making even small but sustained improvements in their blood glucose levels.”

People with type 1 diabetes are routinely still receiving poorer care and are less likely to be meeting NICE recommended blood glucose targets, when compared to people with type 2 diabetes.
Karen Addington, chief executive of JDRF in the UK said: “People with type 1 diabetes are routinely still receiving poorer care and are less likely to be meeting NICE recommended blood glucose targets, when compared to people with type 2 diabetes.

“The IMPACT 2 results show the benefit to people living with type 1 diabetes and the NHS in providing appropriate care, support and education to help people manage their condition.”

Chris Askew, Diabetes UK chief executive added: “IMPACT 2 demonstrates that even small improvements in blood glucose levels can result in huge benefits for people with diabetes with the potential to stop 23,000 people suffering severe kidney failure, almost 160,000 leg ulcers and amputations and over 50,000 people suffering severe loss of vision.

“This should be a priority for all those involved in providing care for people with diabetes. Preventing type 2 diabetes through public health initiatives is of course the best way of reducing spend long-term, however much greater efforts are needed to ensure all people with diabetes get the support and care they need for a good quality of life and better health outcomes.”

The NHS spend on diabetes is already considerable and on the increase. IMPACT 1 showed that diabetes costs the NHS £10 billion each year, which equated to around £1 million an hour.

Nearly 80 per cent of these costs are attributable to treating avoidable complications, which could potentially be reduced through better management of diabetes, including improved blood glucose control.

And how can that be achieved it would pay them to give T2's meters and strips to self test and to support LC diets.

I've come in on this a bit late but I'm all for testing regularly each day. I was diagnosed T2 in June 2006 and from then until early last year (2015) was on twice daily insulin injections an testing 2/3times a day depending on what I was doing I.e. shopping trips, long distance drives. In January 2015 I developed a major sacral pressure sore and one of the first indicators of there being a problem was when my blood sugar readings suddenly went sky high (25-30mmols) and I was admitted via AandE to my local Spinal Injury Unit as I am Spinal Cord injury at C5 (Quadriplegic). While I was having the sore repaired they also sorted out my blood sugars etc. and things improved so much that they were able to take me off insulin and replace it with Metformin (500mg twice a day which was later increased to 2x500mg in the morning just before breakfast and 500mg in the evening). A couple of months after I was discharged I had problems with my leg and feet
which meant I had to attend the Diabetes Foot Clinic where the doctors added Gliclazide to the mix, 500mg to be taken with my evening meal. At no time was I ever told not to test my bloods so in combination with testing I keep a daily food diary so I can see what food has an effect various foods have on my blood sugar levels during the day. I do my tests before breakfast, before my tea evening meal, and during the evening. In brief my message is on Metformin or not keep testing because your levels can be a good indicator of any potential health problems especially if like me you are SCI and need to be aware of the potential for pressure sores and without the assistance of others it is difficult to for you yourself to check vulnerable areas.
In other words "Keep On Testing"

Nice guidelines state that diet controlled or Metformin only don't need to test.

Are you taking Metformin in the morning and not having breakfast? Because thats not good.

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I too have metformin and don’t get test strips unless I buy them as was told - don’t need to test. However when I go to the optician or even other non diabetes related dr appointments, I am always asked and how is your diabetes, is it under control. How the hell do I know if I don’t test! Also again if I feel unwell I test to see if high or low which I cannot do without strips but apparently I don’t need to test!?

Do doctors know? Go straight to DVLA they know all. Do not test have a crash in your car, while driving you must test every 3 hours or lose your lience. So yes you have to test.

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That does not apply to people on Metformin, diet only, or many other diabetes drugs. It only applies to those on insulin or drugs that stimulate the pancreas to produce extra insulin. In other words, only to those likely mto suffer with hypos.

Doctor knows best?
I was really disturbed by a programme on R4 at lunch time today where doctors were saying patients should not have blood test originated in the home done privately because they would not understand them properly and it would worry the patients concerned.

I don't know about you, it is not knowing that bothers me and GPs are not infallible.

What really steamed me up was a Prof of medicine that disuaded a guy who wanted a prostate specific antigen test to not having one.
Criminal I call it.
I asked for one 19 years ago but my doctor wouldnt do it although my daughter recommended I got one.
Four years later I insisted I had one and I more or less browbeat my doctor into giving me one!

A high reading and biopsies and scans later revealed I had a bilateral stage three carcinoma that required radical radiotherapy for eight weeks and three years hormone therapy.

Don't let them over rule your gut and reasoned belief with a supercilious doctor knows best, attitude. It your life in the balance not theirs.
D.

He's wrong. I've read the research that suggests monitoring one's BG is likely to cause stress. That might be right but losing a limb is probably more stressful, so monitoring is essential.

I use to take Gliclazide and Januvia before lowering my carb intake to less than 50gms per day. I was able to stop taking those two medications within weeks of this new regime and have only taken Metformin for the last 4 or 5 years. Had I not monitored I would have not noticed my BG rising, despite low carb, and would have had to wait for an HbA1c and then be prescribed more medications again. By monitoring I was able to do something about it.

Don't think about the advice this "stranger" has given, do what is best for you.